Neurosarcoidosis: rare initial presentation with seizures and delirium

Besur, Siddesh; Bishnoi, Ravin Kumar; Talluri, Siva

doi:10.1093/qjmed/hcq194

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…In some pathophysiologically disturbed cases, we observe neuropsychiatric symptoms such as epileptic seizure and delirium [19, 20]. Several studies have shown that epilepsy occurs in line with autonomic imbalance, an increased sympathetic activity and a reduced parasympathetic activation [21, 22].…”

Section: Discussionmentioning

confidence: 99%

Auricular Acupuncture at the “Shenmen” and “Point Zero” Points Induced Parasympathetic Activation

Arai

Sakakima²,

Kawanishi³

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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Purpose. Since auricular acupuncture is a diagnostic and treatment system based on normalizing the body's dysfunction, auricular acupuncture has been applied for pain relief, relaxation, and so on. These techniques would modulate the autonomic nerve system, thereby inducing the above-mentioned effects. The aim was to see the effect of auricular acupuncture applied to the “Shenmen” and “Point Zero” points on the postoperative heart rate variability (HRV). Methods. Twenty-six patients who underwent hemicolectomy under general anesthesia were randomized into the control or the acupuncture group. After the operation and before emergence, the acupuncture group received auricular acupuncture. An electrocardiographic unit was placed for recording the autonomic nervous activities. Results. The low frequency (LF)/high frequency (HF) ratio of HRV increased (P = 0.0007) in the control, but the ratio in the acupuncture did not change. There were significant differences between the ratios of the two groups at 3 : 00, 4 : 00, and 5 : 00. HF of the acupuncture group tended to be higher. HFs of the acupuncture group were significantly higher than those of the control group at 3 : 00, 4 : 00, and 5 : 00. Conclusion. Auricular acupuncture kept the LF/HF ratio at lower levels and HF at higher levels during postoperative period in the patients who had undergone hemicolectomy.

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Section: Discussionmentioning

confidence: 99%

Auricular Acupuncture at the “Shenmen” and “Point Zero” Points Induced Parasympathetic Activation

Arai

Sakakima²,

Kawanishi³

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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“…5,19 The CSF may present hyperproteinemia in 73% of the patients and lymphocytosis in 55%; normal CSF is uncommon. 2,5,11 The non-caseating granuloma of sarcoidosis has immunological origin, and is formed by giant cells and epithelioid cells (consisting of histiocytes modified by T lymphocytes). The presence of giant and epithelioid cells is a sign of high cellular turnover.…”

Section: Discussionmentioning

confidence: 99%

“…4 The clinical presentation of neurosarcoidosis is usually optic neuropathy, facial paralysis, meningitis, chronic meningitis, diabetes insipidus, hydrocephalus, elevated intracranial pressure, spinal cord syndromes, vasculitis, cerebral infarction, dysfunctional hypothalamus, myelopathy, myopathy, peripheral neuropathy, and encephalitis (►Table 1); the presentation of psychiatric symptoms and osseous involvement is rare. 3,[10][11][12][13][14] Cranial nerve alteration is present in 50-75% of the patients with neurosarcoidosis, and the most common affected nerves are, in descending order, cranial nerves VII, II and VIII. Cranial nerve VII is unilaterally affected in 65% of the cases, and bilaterally affected in 35%; 7,15 cranial nerve II is affected in 5-25% of the patients.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Neurosarcoidosis Associated with Psychiatric Symptoms: Case Report

et al. 2017

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Background Sarcoidosis is a granulomatous disease predominant in women and black men that has inflammatory origin of unknown etiology; neurosarcoidosis is a rare and critical presentation of the disease. Case description A 26-year-old black female presented frontal headache for 1 year, as well as behavioral and mood changes for 15 days. Skull tomography and nuclear magnetic imaging of the skull revealed damaged meninges, a right frontal bone lesion, and an intraparenchymal contrast-enhancing lesion. Screening with computed tomography (CT) scans was performed, and it showed signs of bronchiectasis in the lower third of the right lung, but it was asymptomatic. The biopsy showed signs of reactional lesion with the presence of non-caseating granulomas. After the treatment with corticosteroids, the patient presented progressive improvement. Conclusions Neurosarcoidosis is a rare and critical pathology of sarcoidosis that presents a lytic bone lesion and clinical psychiatric symptoms; neurosarcoidosis is also rare in the literature.

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“…These symptoms are observed in NS (8,9). NS tends to have a poor outcome if presented with epileptic seizures initially (5,10). In spinal cord involvement of sarcoidosis, para/tetra paresis, autonomic dysreflexia, radicular syndrome, or cauda equine syndrome can be observed because of transverse myelopathy (11,12,13,14,15).…”

Section: Discussionmentioning

confidence: 99%

“…Along with the detection of nonspecific findings, such as protein increase, the levels of leukocytosis or pleocytosis, ACE (21,22), immune globulin G index, CD4:CD8 lymphocyte ratio (23), an increase of beta 2-microglobulin, and the positivity of oligoclonal band (OCB) in CSF provides important clues for NS diagnosis. However, CSF examination can be normal in NS cases (5,18,24). In 6 of our cases, an increment in protein and ACE levels was detected in CSF examinations; pattern III OCB positivity in one case and pattern IV OCB positivity in one case were observed.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Treatment in Neurosarcoidosis

Gözübatik-Çelik¹,

Uygunoğlu²,

Uludüz³

et al. 2015

Arch Neuropsychiatr

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Sarcoidosis is an inflammatory multisystem disorder, affecting many systems such as lung, lymph nodes, skin and eye involvement. Nervous system involvement is often seen in 5-15% of patients with systemic sarcoidosis in the first two years. Preceding to systemic involvement the initial symptom as neurological complaints has been rarely reported. Lacking of any specific, clinical and / or radiological findings for neurosarcoidosis in these cases, it could be difficult to make an accurate diagnosis and histopathological evaluation may be required. Due to rarity and complexity diagnosis of the neurosarcoidosis, in this study, clinical, radiological and / or histopathological features, treatment modalities of the 7 neurosarcoidosis patients to be presented with detailed investigations of different neurological symptoms were evaluated.

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Neurosarcoidosis: rare initial presentation with seizures and delirium

Cited by 7 publications

References 5 publications

Auricular Acupuncture at the “Shenmen” and “Point Zero” Points Induced Parasympathetic Activation

Auricular Acupuncture at the “Shenmen” and “Point Zero” Points Induced Parasympathetic Activation

Neurosarcoidosis Associated with Psychiatric Symptoms: Case Report

Diagnosis and Treatment in Neurosarcoidosis

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